Organization
ATLANTIC UROLOGY CLINIC LLC
Active
Parent organization
ATLANTIC UROLOGY CLINIC LLC
Other names
IOD-CUC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATLANTIC UROLOGY CLINIC LLC
Authorized official
DEBBIE L BOLIG (DIRECTOR OF REVENUE CYCLE)
(843) 347-2450
Entity
Organization
Contact information
Practice address
135 PROFESSIONAL PARK DR, CONWAY, SC 29526-9261
(843) 347-2450
Mailing address
611 BURROUGHS AND CHAPIN BLVD STE 105, MYRTLE BEACH, SC 29577-3200
(843) 347-2450
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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